How to Start a NEMT Business in Maine (2027)

Maine runs MaineCare rides through regional brokers, and in 2026 it is moving to one. On the state’s July 1, 2026 broker list, Modivcare arranges rides in six of the eight regions and Penquis in the other two, and on August 4, 2026 the state’s highest court upheld Modivcare’s award for those two. To get the work, you need a company, vehicles registered and insured for hire, and drivers who meet MaineCare’s rule. The rules below follow Chapter II, Section 113 of the MaineCare Benefits Manual, effective April 5, 2015.

How Medicaid rides work in Maine

The Maine Department of Health and Human Services runs MaineCare through its Office of MaineCare Services (OMS). Since August 2013, OMS has used brokers under a federal 1915(b) waiver to manage, authorize, and pay for non-emergency transportation (NET). CMS’s 2014 profile calls the program an at-risk prepaid ambulatory health plan: the state pays each broker a set rate, and the broker pays the transportation companies. An independent actuary, Deloitte as of September 2025, sets the broker rates.

In November 2025, DHHS counted 1.86 million NET rides (more than 2 million a year before the pandemic), 27,158 members who used NET in state fiscal year 2024, and more than 100 Maine-based transportation companies that give the rides.

Brokers work in the eight transit regions MaineDOT uses. Here are the regions, with each broker as of the state’s July 1, 2026 list:

Region	Counties	Broker
1	Aroostook, plus Danforth and Patten	Modivcare
2	Hancock and Washington (except Danforth)	Modivcare
3	Penobscot (except Patten) and Piscataquis	Penquis
4	Kennebec and Somerset	Penquis
5	Waldo, Knox, Lincoln, Sagadahoc, plus Brunswick and Harpswell	Modivcare since July 1, 2026
6	Cumberland, except Brunswick and Harpswell	Modivcare
7	Androscoggin, Franklin, and most of Oxford	Modivcare
8	York, plus nine Oxford County towns	Modivcare

The move to Modivcare in every region

In 2023, DHHS put all eight regions out to bid under RFP 202303047 and awarded every one to Modivcare. The two community action agencies that ran regions then appealed. On February 10, 2026, the Maine Supreme Judicial Court rejected Waldo Community Action Partners’ challenge to the Region 5 award (2026 ME 13), and Modivcare took over the midcoast on July 1, 2026. Modivcare announced on May 4, 2026 that it would work with Waldo CAP in Region 5. See the midcoast change.

Penquis challenged the awards for Regions 2, 3, 4, and 8. The court upheld all four on August 4, 2026 (2026 ME 79), ending the appeal that had put those awards on hold. While it was pending, the state extended Penquis’s agreements for Regions 3 and 4 from July 1 through December 31, 2026. Until the state’s broker list changes, Penquis arranges rides in Kennebec, Somerset, Penobscot, and Piscataquis. See the court ruling and our Penquis guide.

That is a lot of work changing hands: from April through June 2026, Penquis arranged 170,034 trips, about 32 percent of all NET trips in the state.

Who rides and how trips are booked

A member qualifies when they have no other way to reach a MaineCare-covered service. Covered trips include medical visits, pharmacy trips, and services in a member’s home and community waiver plan. Members with only a Medicare Savings Program, such as QMB or QI, and no full MaineCare benefit do not get NET.

Members call the broker at least two business days before a routine appointment. Urgent trips, dialysis, and hospital discharges have no waiting period. As of August 2026, out-of-state trips need at least seven business days’ notice and DHHS approval in advance.

The broker picks the ride that fits the member’s needs at the lowest cost: public transit, mileage paid to the member or a friend or volunteer, a taxi, rideshare, an agency vehicle, or a wheelchair vehicle. DHHS calls NET a shared ride program, so expect to carry several riders at once.

How to join the broker for your region

Section 113 requires the broker to hold a MaineCare provider agreement. Transportation companies sign a service agreement with the broker, and the broker must send every service agreement to DHHS for review. Ask your broker whether your company must also enroll with MaineCare.

Joining Modivcare

1. Confirm your region. Modivcare runs rides in every county except Kennebec, Somerset, Piscataquis, and most of Penobscot today, and it holds the award for those four too.
2. Set up your company and vehicles first. Register, insure, and inspect each vehicle, as the sections below explain.
3. Fill out the Become a Transportation Provider form. It asks for your company details, owners, NPI, tax ID, service levels, vehicle count, hours, counties served, and your insurance amounts.
4. Credential your drivers and vehicles. Modivcare asks for a PASS wheelchair certificate, first aid and CPR, a defensive driving certificate, a drug screen, a motor vehicle report, and a background check for each driver. For each vehicle, it asks for current registration, a state inspection, and proof of insurance.
5. Sign the service agreement. After that, you use Modivcare’s provider portal for ride reservations, billing, and claims.

In August 2026, Modivcare said it looks forward to partnering with local providers as it expands into the Penquis regions. In February 2026, DHHS told members that Modivcare came out of its 2025 bankruptcy on December 29, 2025, and that nothing changed for their rides. Our Modivcare guide covers its other states, and broker credentialing covers the paperwork.

Joining Penquis

Penquis looks for transportation companies in Penobscot and Piscataquis counties, especially ones that can carry wheelchair users or children. Its provider contact line is (207) 974-2404. Its provider credentials list asks for these on every driver:

• Before the first trip: a copy of the driver’s license and the background checks below.
• Every two years: a Maine child abuse and neglect record check from DHHS, a driving record from the Bureau of Motor Vehicles, a State Bureau of Identification criminal check, and a national sex offender registry search.
• Every year: a federal exclusion check on SAM.gov.
• Within 30 days of hire: PASS, first aid and CPR, and defensive driving certificates, with proof of a refresher each year.

Because Modivcare holds the award for these counties, apply to both if you drive there.

Rules every broker network follows

• Federal minimums. No provider or driver may be excluded from federal health programs, every driver needs a valid license, and each provider needs a process for drug law violations and for reporting drivers’ driving history. See the OIG exclusion list.
• Tribes. Brokers must sign a service agreement with any federally recognized tribe in their region that wants to provide rides and meets the requirements, at rates no lower than other providers get. See tribal NEMT.

Licenses and registrations

Your company

Form an LLC with the Maine Secretary of State on Form MLLC-6, the Certificate of Formation, for $175. Next-business-day filing costs $50 more, and same-day filing $100 more. As of September 2026, the Secretary of State says corporate filings take 25 to 30 business days. Using a trade name different from the LLC’s name means filing an assumed name statement for $125.

An LLC files its first annual report between January 1 and June 1 of the year after it forms, then every year by June 1. The fee is $85, plus a $50 late penalty. If the report is not filed or its fees are not paid, the Secretary of State can administratively dissolve the company.

Get your employer identification number (EIN) from the IRS, which never charges for one. Get an NPI too, since Modivcare’s form asks for it: see how to get an NPI number.

Bureau of Motor Vehicles and your town

Section 113 puts driver and vehicle checks on the broker and adds no separate NEMT license. The state and local steps are:

Step	Who	What it costs
Register each vehicle for hire	Bureau of Motor Vehicles	$70 for a passenger vehicle, or $35 with wheelchair equipment
Buy for-hire insurance	Your insurer	Minimums by seat count, below
Yearly safety inspection	A licensed inspection station	Up to $12.50, or up to $18.50 for the Cumberland County check
Vehicle for hire license	Your town, if it has one	Set by the town

The for-hire fee is double the regular $35 passenger vehicle fee, unless the vehicle has adaptive equipment that makes it accessible to riders with disabilities. The BMV lists the Hire plate at $70 as of September 2026.

Maine law lets towns license vehicles for hire and require insurance before they do. Ask your town clerk before your first paid ride.

Larger vehicles add federal steps. Maine requires a USDOT number for in-state work when a vehicle’s registered gross weight is 10,001 pounds or more, and for trips across state lines in a vehicle designed or used for more than 8 passengers, driver included, for pay. A vehicle designed for 16 or more people, driver included, needs a driver with a commercial license. See DOT numbers for NEMT and NEMT license requirements.

Vehicle rules

Every vehicle registered in Maine gets a safety inspection once a year at a licensed dealership, service station, or garage. It covers brakes, lights, tires, steering, mirrors, glass, exhaust, and seat belts, and Cumberland County vehicles also get an emissions check. A vehicle over 10,000 pounds gross weight used in business gets the yearly commercial vehicle inspection, which follows the federal standard. Brokers must also verify and document that each provider meets the requirements in their state contract.

On every MaineCare trip, Section 113 requires that:

• Every passenger is secured before the vehicle moves: seat belts, wheelchair restraints and tie-downs, and child safety seats.
• No one smokes in any vehicle used for NET.
• Mobility devices are secured and stored before the vehicle moves.

Maine’s child seat law applies too: rear-facing under age 2, a harnessed seat under 55 pounds, and a booster for children under 8 who are under 80 pounds and 57 inches. Children under 12 ride in the back seat when possible. See children in NEMT.

Wheelchair vehicles must meet ADA rules:

• At least 56 inches from floor to ceiling in the passenger area.
• A powered lift, or a secure manual ramp the rider can use.
• An interlock on powered lifts that keeps the vehicle in park with the emergency brake set while the lift is out.
• An ADA tie-down at each wheelchair position.
• For scooters, the rider may move to a seat, or stay on the scooter with the scooter tied down and a separate seat belt.

Run the vehicle inspection checklist before a broker visit, and train drivers on wheelchair securement.

Driver rules and training

Section 113 makes each broker enforce these rules for every driver and attendant under a service agreement:

• A current license for the vehicle driven. Attendants must be at least 18.
• No more than two chargeable accidents or moving violations in the last three years.
• No suspended or revoked license in the last five years. A suspension for unpaid child support is the exception, once the court releases it and the driver stays current for 90 days.
• Two at-fault moving violations or accidents on NET trips during the service agreement disqualify a driver.
• No Class A, B, or C conviction or felony for a violent or sexual crime within 10 years after the sentence ends, or for a drug crime within 7 years. After that, the broker must approve the hire.
• Any other Class A, B, or C conviction or felony in the last five years needs the broker’s approval. So does a misdemeanor for a violent, drug, or sexual crime, before unsupervised contact with members.
• No known abuse of alcohol or drugs that would endanger riders. A driver suspected of driving impaired comes off the road immediately.

Training is due within 30 days of starting under a service agreement or of hire: patient assistance such as PASS, defensive driving, customer service, and cultural and disability sensitivity. First aid and CPR certification is due within 60 days, though Penquis asks for it within 30.

On the job, drivers wear a badge with the company name and their own name. They do not wear headphones, apart from one earpiece that is part of the company’s two-way communication system. They never use a handheld phone while driving. They wait at least 10 minutes past the pickup time and call the broker before leaving a rider behind.

Children under 16 need an adult escort unless the broker has a parent’s signed consent, good for up to 12 months. For a child under 12, the driver hands the child to an authorized adult at drop-off, without leaving other riders alone in the vehicle. Keep each driver’s records in a driver file. For the rules in other states, see NEMT driver requirements.

Trip rules and how you get paid

Section 113 defines on-time service like this:

Trip part	On time
Pickup at home	30 minutes before to 15 minutes after the set time
Drop-off at the appointment	30 minutes before to 5 minutes after the set time
Scheduled return pickup	Up to 30 minutes after the set time
Will-call return	Within 1 hour of the call in urban areas, 2 hours in rural areas

Urban and rural follow MaineDOT’s list of urban areas. The state’s broker contracts require at least 85 percent of trips on time. From April through June 2026, DHHS reported monthly averages of 92.54 percent for Modivcare and 90.26 percent for Penquis.

Other rules that shape your day:

• No-shows. A rider who is not at the pickup within 10 minutes is a no-show. MaineCare does not pay for a trip where no member rode, so whether you get anything depends on your service agreement. Members who miss three rides in 60 days get mileage or bus passes for 90 days instead.
• Standing orders. Recurring trips at least one day a week, such as dialysis, methadone treatment, adult day health, and supported employment. The broker rechecks each one at least every 90 days.
• Escorts. One escort rides free with members who are blind, deaf, under 21, or have an intellectual disability, autism, or a brain injury. Neither the member nor MaineCare pays for an escort or an attendant.

The broker reports each trip to MaineCare by the 15th of the next month with these codes:

Code	What it covers	Unit
T2003	Base rate for a one-way trip	Per trip
S0215	Mileage in an agency vehicle	Per passenger mile
S0215 TK	Shared-ride mileage in an agency vehicle	Per mile
A0130	Wheelchair van trip	Per trip
S0209	Wheelchair van mileage	Per passenger mile

The report carries the date, your company name, the time the vehicle leaves your base, the pickup and drop-off addresses, the time it returns to base, your authorized signature on file, and the miles. Log all of it on a trip log.

The state does not set your rate. You are paid under the rates in your service agreement, and the state sets rates only for drivers without one, such as family and friends. Section 113 sets no payment deadline, so get the payment terms in writing. If you have a problem with a broker, file a complaint with it: brokers must report every complaint and its resolution to DHHS.

Insurance requirements

Maine law sets minimum auto liability for vehicles that carry passengers for hire within the state. The limits are combined single limits, based on the seats behind the driver:

Seats behind the driver	Minimum
Up to 3	$125,000, or split limits
4 to 7	$300,000
8 to 15	$750,000
16 to 30	$1,500,000
31 or more	$2,000,000

For up to 3 seats, the split limits are $50,000 per person and $100,000 per accident for injuries, plus $25,000 for property damage. Trips that cross state lines need $1.5 million for vehicles with 15 or fewer passengers and $5 million for 16 or more. Otherwise the registration is marked “intrastate only.”

Your insurer files proof of coverage with the Secretary of State on Form JB, Maine’s insurance certificate for for-hire passenger vehicles. For passenger carriers, the policy must give primary coverage to the driver as well as the owner. A cancellation takes effect only 30 days after the state receives the insurer’s Form K notice, and the state suspends the registration of any vehicle whose coverage lapses. See combined single limit.

Modivcare’s provider page asks for commercial general liability, abuse and molestation coverage, auto liability, and workers’ compensation, with limits that vary by state. Ask for Maine’s limits in writing before you buy a policy. For what brokers ask for elsewhere, see NEMT insurance requirements.

Maine requires every private employer to carry workers’ compensation for all of its employees. Owners are treated differently. A sole proprietor, partner, or LLC member is covered only by choosing personal coverage on a policy. An owner of at least 20 percent of a corporation’s voting stock can waive coverage in a written statement to the Workers’ Compensation Board.

What it costs and how long it takes

These are the fees Maine law sets as of September 2026. Vehicles, equipment, and insurance premiums depend on your quotes. See what it costs to start a NEMT business.

Item	Cost	Paid to
EIN	Free	IRS
LLC Certificate of Formation	$175, plus $50 or $100 to expedite	Secretary of State
LLC annual report	$85 a year, $50 more if late	Secretary of State
Assumed name, if you use one	$125	Secretary of State
For-hire registration	$70 a vehicle, or $35 with wheelchair equipment	Bureau of Motor Vehicles
Safety inspection	Up to $12.50, or up to $18.50 in Cumberland County	Inspection station

A workable order, from first call to first trip:

1. Call the broker for your county. Ask which service levels it needs most. Penquis says it especially needs wheelchair and child transport in Penobscot and Piscataquis.
2. Form your company and get your EIN and NPI.
3. Ask your town whether it licenses vehicles for hire.
4. Buy insurance at or above the state minimum for your seat count and the broker’s limits.
5. Register each vehicle for hire with the Bureau of Motor Vehicles and pass the state inspection.
6. Equip wheelchair vehicles to the ADA list and stock child seats.
7. Hire drivers who meet Section 113, and run their background and exclusion checks.
8. Apply to the broker, credential your drivers and vehicles, and sign the service agreement.

Plan around the Secretary of State’s 25 to 30 business days for a filing, unless you pay to expedite. Ask the broker how long credentialing takes before you buy or lease vehicles. For the same steps in any state, see how to start a NEMT business.

Work beyond Medicaid

DHHS lists long distances to care and thin rural transit among the program’s challenges, so a second source of rides matters. See rural NEMT for how to keep long trips profitable.

• Public transit agencies. MaineDOT lists a public transit provider for each of the same eight regions, such as Aroostook Regional Transportation Systems in Region 1, KVCAP in Region 4, and York County Community Action Corporation in Region 8. Ask the agency in your region whether it buys rides from private carriers for its own programs.
• Veterans. The VA pays for special mode transportation, such as a specially equipped vehicle, when a VA provider decides a veteran needs it and the trip is approved in advance. Ask your VA health facility how it books these rides. See VA beneficiary travel.
• Facilities and private pay. Dialysis centers, hospitals, and senior living communities, along with riders who pay for themselves, add work that does not depend on one broker. You can share a ride between private riders and MaineCare members only if each private fare is at least the member rate. See how to get NEMT facility contracts.